| NPI | 1053425462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-100016) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT RN14131) |
| 363LF0000X Nurse Practitioner, Family (Licence: WY 11007.1632) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2020-09-01 |