| NPI | 1053568014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP124889) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: IN 71002688) |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2016-07-20 |