| NPI | 1568094159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R50650) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 7230) |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2022-02-01 |