| NPI | 1962847178 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 16777) |
| Additional Taxonomies | 363LC0200X Nurse Practitioner Critical Care Medicine (Licence: TX AP136021) |
| 363LF0000X Nurse Practitioner Family (Licence: TN APN0000016777) | |
| 363LF0000X Nurse Practitioner Family (Licence: MI 4704366569) | |
| Enumeration Date | 2013-05-01 |
| Last Update Date | 2022-04-01 |