| NPI | 1124539861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R205350) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP134577) |
| Enumeration Date | 2017-10-21 |
| Last Update Date | 2018-07-09 |