| NPI | 1972628527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP108622) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: TX 243431) |
| Enumeration Date | 2007-03-20 |
| Last Update Date | 2015-10-16 |