| NPI | 1710267877 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 176676-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 176676-8900) |
| 363L00000X Nurse Practitioner (Licence: UT MH2422373) | |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2011-08-22 |