| NPI | 1669725925 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP124768) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 846454) |
| Enumeration Date | 2012-10-23 |
| Last Update Date | 2017-04-03 |