| NPI | 1265786487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 8023) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 164596-9) |
| Enumeration Date | 2012-11-09 |
| Last Update Date | 2022-10-06 |