| NPI | 1861417222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP113635) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP006296B) |
| 363L00000X Nurse Practitioner (Licence: TX 711447) | |
| 363L00000X Nurse Practitioner (Licence: NJ 26NN09531000) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2021-06-23 |