| NPI | 1508467788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R41374) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 7760) |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2020-11-04 |