| NPI | 1003248576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: CA 1003248576) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MN 2013001175) |
| Enumeration Date | 2013-08-06 |
| Last Update Date | 2019-05-06 |