| NPI | 1265419857 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: SC 19676) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R145287-7) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2015-08-18 |