| NPI | 1639625965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131244) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 763846) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2016-08-29 |