| NPI | 1154478311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 441922) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 198018-7) |
| Enumeration Date | 2007-01-03 |
| Last Update Date | 2020-01-16 |