| NPI | 1548588189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP136542) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: GA LPN078290) |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2019-01-14 |