| NPI | 1538269766 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT APRN100064)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT RN10813)  | 
| Enumeration Date | 2006-09-25 | 
| Last Update Date | 2020-05-14 |