| NPI | 1417423369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704279511) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP140290) |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2022-03-02 |