| NPI | 1770185068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-163532) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT NUR-APRN-LIC-163532) |
| Enumeration Date | 2020-11-11 |
| Last Update Date | 2024-11-11 |