| NPI | 1700136009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP128039) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 4970-33) |
| Enumeration Date | 2012-09-13 |
| Last Update Date | 2023-02-02 |