| NPI | 1659810026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MT NUR-APRN-LIC-125211) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MT NUR-APRN-LIC-125211) |
| Enumeration Date | 2017-02-18 |
| Last Update Date | 2022-07-01 |