| NPI | 1790978088 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 601620) |
| Additional Taxonomies | 163WA2000X Registered Nurse, Administrator (Licence: TX 601620) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2008-03-31 |