| NPI | 1194108720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ND R28884) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN CNP3959) |
| Enumeration Date | 2015-07-01 |
| Last Update Date | 2017-12-22 |