| NPI | 1053647461 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 832072) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP123412) |
| 363LF0000X Nurse Practitioner Family (Licence: MA RN233973) | |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2020-04-13 |