| NPI | 1164415006 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP130662) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71001866A) |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2020-09-03 |