| NPI | 1639683576 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP136011) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP136011) | 
| Enumeration Date | 2017-11-30 | 
| Last Update Date | 2017-12-08 |