| NPI | 1598017063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 851586) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60318378) |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2015-06-12 |