| NPI | 1578809935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 826295) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2269414) |
| Enumeration Date | 2012-12-12 |
| Last Update Date | 2013-09-19 |