| NPI | 1164575452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 1104) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 657315) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2012-12-11 |