| NPI | 1003167610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R 210222-3) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0990678-NP) |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2024-05-21 |