| NPI | 1871954594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 6695380-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 6695380-8900) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2016-03-08 |