| NPI | 1487661633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 5127) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 104969) |
| 363LF0000X Nurse Practitioner, Family (Licence: KS 44693) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MO 104969) | |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2020-06-01 |