| NPI | 1205244506 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: LA AP08752) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX AP126027) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2016-06-28 |