| NPI | 1982003125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP125806) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 784577) |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2014-12-11 |