| NPI | 1336159888 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 624432) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010000) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2016-03-22 |