| NPI | 1699101121 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 679935) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 679935) | 
| Enumeration Date | 2013-09-16 | 
| Last Update Date | 2013-09-16 |