| NPI | 1275714180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 753655) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN168447) |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2013-01-22 |