| NPI | 1245772359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R38295) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: ND R38295) |
| Enumeration Date | 2016-11-07 |
| Last Update Date | 2017-02-03 |