| NPI | 1730579814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP127223) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 735041) |
| Enumeration Date | 2015-01-28 |
| Last Update Date | 2015-01-28 |