| NPI | 1255636023 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 746332) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339174) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2015-06-04 |