| NPI | 1578508511 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 37252.1493) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 518267) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2016-03-08 |