| NPI | 1639453079 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129594) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 533266) |
| Enumeration Date | 2011-10-04 |
| Last Update Date | 2016-10-27 |