| NPI | 1265518633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 219067-4402) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 219067-4405) |
| Enumeration Date | 2006-10-28 |
| Last Update Date | 2010-12-20 |