| NPI | 1902088289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP130683) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX 640965) |
| Enumeration Date | 2007-11-28 |
| Last Update Date | 2016-04-19 |