| NPI | 1790079523 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 810425) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R031872) |
| 163WP2201X Registered Nurse, Ambulatory Care (Licence: TX 810425) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2015-09-17 |