| NPI | 1295211985 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-131453) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT NUR-RN-LIC-39547) |
| Enumeration Date | 2018-07-16 |
| Last Update Date | 2018-08-18 |