| NPI | 1316171903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R29030) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 189345-2) |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2009-05-11 |