| NPI | 1922519131 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MT NUR-APRN-LIC-128564) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MT 128564) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-10-14 |
| Last Update Date | 2018-04-04 |