| NPI | 1144870866 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-193378) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 8638762-4405) | 
| Enumeration Date | 2019-09-14 | 
| Last Update Date | 2022-10-06 |