| NPI | 1912139171 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 367032-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 3670324405) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 367032-8900) | |
| Enumeration Date | 2009-08-20 |
| Last Update Date | 2013-01-15 |