| NPI | 1578237996 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1114006) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704352831NSA210HA) |
| Enumeration Date | 2021-08-09 |
| Last Update Date | 2024-04-26 |