| NPI | 1447259395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R199048-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 704855) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2021-07-16 |