| NPI | 1750411005 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP113570) | 
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: TX 710722) | 
| 363L00000X Nurse Practitioner (Licence: TX 710722) | |
| Enumeration Date | 2007-03-06 | 
| Last Update Date | 2021-07-16 |