| NPI | 1164805057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 111782) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP127692) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2016-11-08 |