| NPI | 1982055091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131322) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 771214) |
| Enumeration Date | 2016-06-29 |
| Last Update Date | 2017-03-23 |