| NPI | 1235680190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT NURS-APRN-LIC-126681) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT RN-45659) |
| Enumeration Date | 2016-10-16 |
| Last Update Date | 2024-04-05 |