| 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 |