| NPI | 1639208143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 197820-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NV APN00495) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2007-07-08 |