| NPI | 1194719617 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R1419441) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MI 4704252639) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2014-08-28 |