| NPI | 1386468940 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1176800) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704354461) | 
| Enumeration Date | 2024-11-11 | 
| Last Update Date | 2024-11-11 |