| NPI | 1891468575 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1074575) | 
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: OH RN.312390) | 
| 163WM0705X Registered Nurse, Medical-Surgical (Licence: MI 4704371688) | |
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX 1074575) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: OH AG06210129) | |
| Enumeration Date | 2021-07-28 | 
| Last Update Date | 2023-09-20 |