| NPI | 1659741106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 100886) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MT 45063) |
| Enumeration Date | 2015-09-28 |
| Last Update Date | 2019-07-23 |