| NPI | 1497750301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 100831) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 100831) |
| 363LF0000X Nurse Practitioner, Family (Licence: NC 200824) | |
| Enumeration Date | 2005-06-16 |
| Last Update Date | 2024-01-08 |