| NPI | 1184988610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A117453) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 11617) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A-117453) | |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2024-12-11 |