| NPI | 1780963538 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 100642) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 32166) |
| Enumeration Date | 2011-08-11 |
| Last Update Date | 2020-05-06 |