| NPI | 1700256658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129226) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP08456) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2015-10-05 |