| NPI | 1619202223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP118340) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 767740) | |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2017-12-29 |