| NPI | 1164859427 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SD CP000823) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R216359-2) |
| Enumeration Date | 2013-10-02 |
| Last Update Date | 2022-03-30 |