| NPI | 1417330895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP128409) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP128409) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP128409) | |
| Enumeration Date | 2015-07-03 |
| Last Update Date | 2017-05-05 |