| NPI | 1184735060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06857) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 724140) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2012-07-18 |