| NPI | 1760693576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP115592) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 648543) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2017-01-10 |