| NPI | 1508248121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN CNP5178) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NE 111811) |
| Enumeration Date | 2015-06-19 |
| Last Update Date | 2021-10-06 |