| NPI | 1487623252 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 7868) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TN 7868) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 7868) | |
| Enumeration Date | 2006-03-15 |
| Last Update Date | 2012-07-16 |