| NPI | 1255397220 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1022167) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ AP4625) |
| 363L00000X Nurse Practitioner (Licence: MO 155922) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2022-02-01 |