| NPI | 1265735559 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 684846) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 684846) | 
| Enumeration Date | 2010-12-08 | 
| Last Update Date | 2016-12-21 |