| NPI | 1821400581 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP125282) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN212354) | 
| Enumeration Date | 2014-05-28 | 
| Last Update Date | 2014-05-28 |