| NPI | 1144658063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 6334) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111578) |
| Enumeration Date | 2013-10-31 |
| Last Update Date | 2021-01-19 |