| NPI | 1528369907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CT 4286) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 824078) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2016-02-01 |