| NPI | 1104313865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A154372) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 5797) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2020-09-23 |