| NPI | 1205297512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN 4445) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP4445) |
| Enumeration Date | 2016-03-14 |
| Last Update Date | 2019-06-28 |