| NPI | 1770735904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX R24960) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 678646) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2021-01-21 |