| NPI | 1407990872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP120850) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 131861) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 811726) | |
| Enumeration Date | 2007-02-17 |
| Last Update Date | 2022-03-17 |