| NPI | 1790870194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 20725) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MI 4704219757) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: MI 4704219757) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 0385214) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2025-10-07 |