| NPI | 1255480463 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 691600) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP115140) | 
| Enumeration Date | 2007-01-09 | 
| Last Update Date | 2024-10-31 |