| NPI | 1376826503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 739362) |
| Additional Taxonomies | 163WR0400X Registered Nurse, Rehabilitation (Licence: TX 739362) |
| Enumeration Date | 2011-09-23 |
| Last Update Date | 2013-04-17 |