| NPI | 1467402628 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 204822-4405) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 204822-4405) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 204822-4405) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2007-07-09 |