| NPI | 1659567360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP113498) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 500410) |
| Enumeration Date | 2007-09-18 |
| Last Update Date | 2017-12-28 |