| NPI | 1861709404 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8227016-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 718791) |
| Enumeration Date | 2010-09-02 |
| Last Update Date | 2014-05-29 |