| NPI | 1962957407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 6993247-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 6993247-8900) |
| Enumeration Date | 2016-08-24 |
| Last Update Date | 2016-08-24 |