| NPI | 1407108772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP125686) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP4649) |
| Enumeration Date | 2012-10-10 |
| Last Update Date | 2018-06-11 |