| NPI | 1235425208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MI 4704210196) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX F0611058) |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2017-04-07 |