| NPI | 1376887398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 25413) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 715241) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 21442) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2022-03-02 |