| NPI | 1396160354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 286628) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP129711) |
| 363L00000X Nurse Practitioner (Licence: MI 4704236507) | |
| Enumeration Date | 2014-02-28 |
| Last Update Date | 2023-07-17 |