| NPI | 1528174828 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 823501) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: KY 42367) |
| 363L00000X Nurse Practitioner (Licence: KY 42367) | |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP009362) | |
| 163W00000X Registered Nurse (Licence: PA RN582105) | |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2014-06-22 |