| NPI | 1801861448 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 818077) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2000164880) |
| Enumeration Date | 2006-02-17 |
| Last Update Date | 2012-09-21 |