| NPI | 1760803662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 846927) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 846927) |
| 163W00000X Registered Nurse (Licence: NY 499921-1) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F338014-1) | |
| Enumeration Date | 2013-12-18 |
| Last Update Date | 2013-12-18 |