| NPI | 1629615109 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1180128) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704276187) |
| Enumeration Date | 2019-12-04 |
| Last Update Date | 2025-04-28 |