| NPI | 1962516526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 213305-4402) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ RN055020) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2013-02-05 |