| NPI | 1518012368 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 577038) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX F1104212) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |