| NPI | 1306977483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO 189142) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 640191) |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2013-09-24 |