| NPI | 1114530771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-161107) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: MT NUR-RN-LIC-30267) |
| Enumeration Date | 2020-08-24 |
| Last Update Date | 2020-09-03 |