| NPI | 1033321674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ID NP578A) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 758472) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 758472) | |
| Enumeration Date | 2007-05-04 |
| Last Update Date | 2013-01-31 |