| NPI | 1174533012 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AK 1348)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 556856)  | 
| Enumeration Date | 2006-08-09 | 
| Last Update Date | 2013-08-26 |