| NPI | 1861867962 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704220892) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX ap129727) |
| Enumeration Date | 2015-12-01 |
| Last Update Date | 2024-08-19 |