| NPI | 1538550611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 5873) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP7642) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: AZ AP7642) | |
| Enumeration Date | 2015-02-11 |
| Last Update Date | 2018-06-27 |