| NPI | 1255627998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 555465) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: TX 555465) |
| Enumeration Date | 2011-06-21 |
| Last Update Date | 2016-12-12 |