| NPI | 1235411505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA 118250) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 201313-4) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2015-09-15 |