| NPI | 1770586612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 569381) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: TX 569381) |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2008-01-07 |