| NPI | 1710370705 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP127349)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 501605)  | 
| Enumeration Date | 2015-03-15 | 
| Last Update Date | 2019-06-13 |