| NPI | 1366973364 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 09237) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 132823) |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2017-03-22 |