| NPI | 1245397637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 268377-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 208377-4405) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2010-09-09 |