| NPI | 1154676229 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2048507) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 1144) |
| Enumeration Date | 2012-07-16 |
| Last Update Date | 2024-05-09 |