| NPI | 1689123481 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8055959-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 8055959-8900) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-12-05 |