| NPI | 1629497508 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: AL 1-177987) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX AP125229) |
| 363LF0000X Nurse Practitioner Family (Licence: TX 828524) | |
| Enumeration Date | 2014-04-08 |
| Last Update Date | 2019-10-11 |