| NPI | 1306188289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP125778) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP125778) |
| 363L00000X Nurse Practitioner (Licence: IL 209009969) | |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2016-09-01 |