| NPI | 1689692394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 614680) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704271101) |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2014-12-12 |