| NPI | 1972700904 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 772550) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 15567) |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 445425) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2009-09-21 |