| NPI | 1104985308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 5371-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R156626-8) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2023-08-23 |