| NPI | 1396149647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP133317) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP08040) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2017-10-23 |