| NPI | 1568866168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 323088-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 323088-8900) |
| Enumeration Date | 2014-10-10 |
| Last Update Date | 2014-10-10 |