| NPI | 1457681967 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP118057) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 645761) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 645761) | |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2022-12-09 |