| NPI | 1417036104 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: OK R0084153) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX AP115719) |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2020-04-23 |