| NPI | 1760594980 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP108262) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 554191) | 
| Enumeration Date | 2006-09-01 | 
| Last Update Date | 2021-11-30 |