| NPI | 1578643979 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP110379) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 642590) |
| 208600000X Surgery (Licence: TX 642590) | |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2019-01-29 |