| NPI | 1235297474 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA Rn178151 NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 709041 FNP-LPA) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-07-08 |