| NPI | 1881664936 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP139229) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 40156) |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2019-05-17 |