| NPI | 1336714997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-174280) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 174280) |
| Enumeration Date | 2021-05-25 |
| Last Update Date | 2021-10-21 |