| NPI | 1568737187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 3621) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN 3621) |
| Enumeration Date | 2012-03-14 |
| Last Update Date | 2019-06-24 |