| NPI | 1508058421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP119934) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN RN0000158152) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 785190) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 5006200) | |
| Enumeration Date | 2007-08-14 |
| Last Update Date | 2015-02-03 |