| NPI | 1780188128 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP144401) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MI 4704256203) |
| Enumeration Date | 2018-03-21 |
| Last Update Date | 2023-03-18 |