| NPI | 1215365648 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 6637)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60495439)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: ND R29871)  | |
| Enumeration Date | 2013-10-22 | 
| Last Update Date | 2025-06-27 |