| NPI | 1124653829 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MT MED-APRN-LIC-148859) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-148859) |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2021-12-14 |