| NPI | 1568619229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 797776) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209007220) |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2014-09-10 |