| NPI | 1255528303 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1046788) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5005526) |
| 363LF0000X Nurse Practitioner Family (Licence: NC 249962) | |
| 363LF0000X Nurse Practitioner Family (Licence: PA SP009542) | |
| Enumeration Date | 2007-10-02 |
| Last Update Date | 2022-01-10 |