| NPI | 1013405711 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-215158)  | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO 0993867)  | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MT NUR-APRN-LIC-215158)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 0993867)  | |
| Enumeration Date | 2018-04-27 | 
| Last Update Date | 2023-09-26 |