| NPI | 1548510431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 4777852-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 4777852-4405) |
| Enumeration Date | 2012-09-18 |
| Last Update Date | 2013-07-18 |