| NPI | 1194155341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 18616) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 719261) |
| 363LF0000X Nurse Practitioner, Family (Licence: GA 229769) | |
| Enumeration Date | 2013-11-24 |
| Last Update Date | 2014-01-28 |