| NPI | 1164896379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 6468) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CO 0992021) |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2020-05-14 |