| NPI | 1255734596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP140188) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704257114) |
| Enumeration Date | 2014-10-01 |
| Last Update Date | 2021-09-08 |