| NPI | 1679246425 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MT NUR-APRN-LIC-176937) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-176937) |
| Enumeration Date | 2021-07-28 |
| Last Update Date | 2022-02-24 |