| NPI | 1841267309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 1966054405) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 1966058900) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2007-07-08 |