| NPI | 1255782132 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ND R35320) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN R-207171-0) |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2018-11-01 |