| NPI | 1679610497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 0390964-22) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 647883) |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2019-01-14 |