| NPI | 1396018818 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 170833) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 183302-7) |
| Enumeration Date | 2012-02-14 |
| Last Update Date | 2018-10-17 |