| NPI | 1730550021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MT NURAPRNLIC101192) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-RN-LIC-73321) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC101192) | |
| Enumeration Date | 2015-10-12 |
| Last Update Date | 2021-12-14 |