| NPI | 1992223762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MI 4704272780) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MI 4704272780) |
| 363L00000X Nurse Practitioner (Licence: TX AP134654) | |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2022-05-20 |