| NPI | 1669645180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 639892) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 639892) |
| Enumeration Date | 2008-04-04 |
| Last Update Date | 2014-03-31 |