| NPI | 1649513540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 674377) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: TX 674377) |
| Enumeration Date | 2013-03-29 |
| Last Update Date | 2017-03-09 |