| NPI | 1073515029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 560571) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: RI NPP37229) |
| 363LF0000X Nurse Practitioner, Family (Licence: MA 243343NP) | |
| Enumeration Date | 2005-06-02 |
| Last Update Date | 2013-07-15 |