| NPI | 1962830885 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP127573) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC APN.18439RX) |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2015-05-05 |