| NPI | 1912988494 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX F0899258) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 564659) |
| 163W00000X Registered Nurse (Licence: TX 564659) | |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2014-09-10 |