| NPI | 1821585209 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-191101) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MT 21321) | 
| Enumeration Date | 2018-04-20 | 
| Last Update Date | 2022-02-17 |