| NPI | 1639123201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 21309) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 150915) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP129453) | |
| Enumeration Date | 2006-05-19 |
| Last Update Date | 2017-05-11 |