| NPI | 1780763193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT NUR-APRN-LIC-100165) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT RN19693) |
| Enumeration Date | 2006-11-04 |
| Last Update Date | 2021-12-14 |