| NPI | 1407190572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP124094) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 22498) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209.009780) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2018-06-20 |