| NPI | 1962900241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1026537) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704327730) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2024-01-25 |