| NPI | 1235510330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP138737) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2016003743) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A139907) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2016003743) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MO 2016003743) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IA A139907) | |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2019-06-27 |