| NPI | 1245433002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP138014) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: IL 209-004886) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2018-07-20 |