| NPI | 1366648701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP115903) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 669250) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-06-30 |