| NPI | 1225570609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R166509) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R241632-0) |
| Enumeration Date | 2016-11-16 |
| Last Update Date | 2018-11-05 |