| NPI | 1104916956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 217181-8900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 217181-4405) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2007-07-08 |