| NPI | 1548557960 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-100601) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 30702) | 
| Enumeration Date | 2011-07-06 | 
| Last Update Date | 2025-04-15 |