| NPI | 1811543762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-146340) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MT RN73800) |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2019-09-05 |