| NPI | 1396152583 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 5097) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MT 25508) |
| Enumeration Date | 2014-07-19 |
| Last Update Date | 2019-09-05 |