| NPI | 1114250909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 774019) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: OK 70627) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2011-04-19 |