| NPI | 1063034460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R37228) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ND R37228) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 7332) | |
| Enumeration Date | 2020-05-08 |
| Last Update Date | 2022-03-31 |