| NPI | 1083015242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 100595) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT F0814197) |
| Enumeration Date | 2014-09-08 |
| Last Update Date | 2019-07-11 |