| NPI | 1275030801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MT NUR-APRN-LIC-144531) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MT 144531) |
| 363LF0000X Nurse Practitioner Family (Licence: CA 21145) | |
| Enumeration Date | 2018-04-10 |
| Last Update Date | 2023-09-13 |