| NPI | 1245213669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP113541) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 655890) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2021-11-23 |