| NPI | 1396722963 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-100497) |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered (Licence: MT RN 28148) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-12-10 |