| NPI | 1144205659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP-01580) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 627894) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2014-09-19 |