| NPI | 1407826753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 800706) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OH NP08171) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2011-08-25 |