| NPI | 1609008655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5013264) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC F0709104) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 612814) | |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2024-07-25 |