| NPI | 1558540930 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP113537) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 613135) |
| 163WG0000X Registered Nurse, General Practice (Licence: TX 613135) | |
| Enumeration Date | 2007-11-01 |
| Last Update Date | 2019-08-06 |