| NPI | 1356571764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 689615) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 689615) |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 689615) | |
| Enumeration Date | 2009-07-20 |
| Last Update Date | 2015-11-04 |