| NPI | 1770500217 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP108665) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 649102) |
| 363L00000X Nurse Practitioner (Licence: CA 363151) | |
| 363L00000X Nurse Practitioner (Licence: TX 649102) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2016-03-10 |