| NPI | 1053729558 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 356) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN F0714753) |
| Enumeration Date | 2014-07-28 |
| Last Update Date | 2023-06-09 |