| NPI | 1972519809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP115103) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OK 102083) |
| 363L00000X Nurse Practitioner (Licence: TX 641318) | |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2021-08-05 |