| NPI | 1184970691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9250523) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN r202921) |
| Enumeration Date | 2012-08-02 |
| Last Update Date | 2013-08-30 |