| NPI | 1336419720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP120303) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 791946) |
| Enumeration Date | 2012-01-03 |
| Last Update Date | 2015-03-06 |