| NPI | 1366802399 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 848359) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704302567) |
| 363L00000X Nurse Practitioner (Licence: MI 4704302567) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71014488A) | |
| Enumeration Date | 2016-03-03 |
| Last Update Date | 2025-04-25 |