| NPI | 1669551081 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX F0806164) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 606234) | 
| Enumeration Date | 2006-11-05 | 
| Last Update Date | 2011-05-24 |