| NPI | 1356641831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R215096-1) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: CA 19890) |
| Enumeration Date | 2010-10-29 |
| Last Update Date | 2014-01-06 |