| NPI | 1598041675 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5006133)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 461498)  | 
| Enumeration Date | 2011-11-02 | 
| Last Update Date | 2013-04-19 |