| NPI | 1578515961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP109151) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 607011) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 607011) | |
| Enumeration Date | 2006-05-16 |
| Last Update Date | 2019-12-06 |