| NPI | 1336661677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 179437) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A138311) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA 138311) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: IA A138311) | |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2021-11-11 |