| NPI | 1669640884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 702062) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX F1107064) |
| Enumeration Date | 2008-02-11 |
| Last Update Date | 2012-03-19 |