| NPI | 1669543039 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MT RN023933)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT RN23933)  | 
| 363LA2200X Nurse Practitioner, Adult Health (Licence: MT NUR-APRN-LIC-100305)  | |
| Enumeration Date | 2006-11-10 | 
| Last Update Date | 2024-07-15 |