| NPI | 1336700970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R34732) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP6752) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2019-07-30 |