| NPI | 1437143955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1050) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R160154-7) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2020-11-09 |