| NPI | 1114111978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS R899737) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 734342) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2016-03-25 |