| NPI | 1821366469 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 817036) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL ARNP 2932322) | 
| Enumeration Date | 2011-12-10 | 
| Last Update Date | 2013-03-27 |