| NPI | 1629398557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP127998) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: TX 11347) |
| 163W00000X Registered Nurse (Licence: TX 825592) | |
| 363AS0400X Physician Assistant, Surgical (Licence: TX 1143) | |
| Enumeration Date | 2010-06-02 |
| Last Update Date | 2022-10-12 |