| NPI | 1164156535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1142627) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 23242) |
| 363L00000X Nurse Practitioner (Licence: MN 9627) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OH F07220468) | |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2024-04-05 |