| NPI | 1376954792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 87616-30) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R102292-2) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2020-06-19 |