| NPI | 1023053907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2010012214) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 655175) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2012-08-06 |