| NPI | 1104824754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AR A01724ANP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX R28820) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2013-10-24 |