| NPI | 1255724159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: OR 10010995APRN-NP) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704328836) |
| Enumeration Date | 2015-03-17 |
| Last Update Date | 2024-04-19 |