| NPI | 1316273204 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN R2068312) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: WA RN60023945) |
| 363LF0000X Nurse Practitioner Family (Licence: WA AP60116836) | |
| Enumeration Date | 2009-10-27 |
| Last Update Date | 2013-09-17 |