| NPI | 1275828469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN 1566) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN R 161374-2) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2018-12-04 |