| NPI | 1194085969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R31754) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1890303) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |