| NPI | 1528489812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TN 26061) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9234874) |
| 363LF0000X Nurse Practitioner Family (Licence: TX AP134689) | |
| Enumeration Date | 2014-01-03 |
| Last Update Date | 2019-11-04 |