| NPI | 1306948815 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 206176-4405) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 206176-4405) |
| Enumeration Date | 2006-09-04 |
| Last Update Date | 2014-07-12 |