| NPI | 1538413794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MO 2014019178) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 206334-6) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2024-10-23 |