| NPI | 1679990352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP125147) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 787765) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95002030) | |
| Enumeration Date | 2014-03-19 |
| Last Update Date | 2020-07-29 |