| NPI | 1528182797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 1289) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN RN132041-7) |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2009-07-17 |