| NPI | 1447661830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11022149) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1174) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R1713419) | |
| Enumeration Date | 2014-05-19 |
| Last Update Date | 2022-12-22 |