| NPI | 1407288905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP123830) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 751706) |
| Enumeration Date | 2013-08-07 |
| Last Update Date | 2017-05-10 |