| NPI | 1891796496 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: UT 02758224405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: UT 02758228900) |
| 363LF0000X Nurse Practitioner Family (Licence: UT 0349373) | |
| 363LF0000X Nurse Practitioner Family (Licence: OR 201603205NP-PP) | |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2017-04-05 |