| NPI | 1013308543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 106630) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 779163) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2019-03-26 |