| NPI | 1073903100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5797157-4405) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 5797157-4405) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2015-08-21 |