| NPI | 1518967256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A077328) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1483752) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2018-03-17 |