| NPI | 1093183873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 4906080-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 4906080-8900) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2015-12-18 |