| NPI | 1376796763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2905) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 1681075) |
| 363LF0000X Nurse Practitioner, Family (Licence: NV APN001089) | |
| Enumeration Date | 2008-10-29 |
| Last Update Date | 2020-09-17 |