| NPI | 1124337860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP4160) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: OH COA.11871-NP) |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2018-10-11 |