| NPI | 1134667538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1020807) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH APRN.CNP.022132) |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: MI 4704277432) | |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2021-09-17 |