| NPI | 1376803163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 6204) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A111160) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 8749-33) | |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2022-08-22 |