| NPI | 1558440040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R24246) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R0922599) |
| 363L00000X Nurse Practitioner (Licence: ND R24246) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2023-04-06 |