| NPI | 1790912657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP01565) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 721608) |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2016-04-12 |