| NPI | 1912270182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 2305) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP012050) |
| Enumeration Date | 2012-02-17 |
| Last Update Date | 2013-05-21 |