| NPI | 1700194453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MT 100692) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 33043) |
| Enumeration Date | 2010-09-15 |
| Last Update Date | 2021-07-14 |