| NPI | 1891781308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP126559) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: AZ 071833) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2015-07-23 |