| NPI | 1295166312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9202017) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 144535-0) |
| Enumeration Date | 2013-11-29 |
| Last Update Date | 2020-07-08 |