| NPI | 1265716187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7580) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 775536) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2015-04-01 |