| NPI | 1649343799 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 753241) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R151931) |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2012-08-23 |