| NPI | 1952627978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 1848) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP05868) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 808329-12068) | |
| Enumeration Date | 2010-04-15 |
| Last Update Date | 2020-03-10 |