| NPI | 1306266085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: LA AP08174) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX AP129738) |
| 363LF0000X Nurse Practitioner Family (Licence: MS R865820) | |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2018-02-08 |