| NPI | 1134667405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NY 341715) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX F0117106) |
| Enumeration Date | 2017-02-07 |
| Last Update Date | 2019-09-11 |