| NPI | 1508860974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA J073230) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 0696743-1) |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2015-01-22 |