| NPI | 1235128877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 217729-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 53869) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2017-01-04 |