| NPI | 1902211824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP132101) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 18813) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2017-04-07 |