| NPI | 1740684505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1134438) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MI 4704278810) |
| Enumeration Date | 2014-10-22 |
| Last Update Date | 2023-10-27 |