| NPI | 1689896706 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 659976) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9217922) | 
| Enumeration Date | 2007-05-02 | 
| Last Update Date | 2009-01-15 |