| NPI | 1700470309 |
|---|---|
| Former Name | SHELBY SULAK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1031033) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 878689) |
| Enumeration Date | 2021-02-24 |
| Last Update Date | 2023-09-12 |