| NPI | 1700109550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 16933) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 137663) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 18670) | |
| Enumeration Date | 2010-03-08 |
| Last Update Date | 2018-08-17 |