| NPI | 1003240813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 836548) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN247547) |
| Enumeration Date | 2013-08-28 |
| Last Update Date | 2015-05-20 |