| NPI | 1104265859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 341193) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP123296) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2019-09-23 |