| NPI | 1164708103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT NUR-APRN-LIC-174670) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA 21349) |
| Enumeration Date | 2011-10-21 |
| Last Update Date | 2021-08-27 |