| NPI | 1356545636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 120133) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 663872) |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2013-03-21 |