| NPI | 1508915703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA 102463) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 735505) |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2021-01-28 |