| NPI | 1578909255 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP-02192) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 751586) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP123194) | |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 751586) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02192) | |
| Enumeration Date | 2013-05-21 |
| Last Update Date | 2019-01-29 |