| 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 |