| NPI | 1811354251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT 144874) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60593679) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT 144874) | |
| Enumeration Date | 2016-01-15 |
| Last Update Date | 2020-11-19 |