| NPI | 1639710403 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP143333) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 0039966) |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 2025035569) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MI 4704432490) | |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2025-10-23 |