| NPI | 1578979233 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP4020) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 28190575A) |
| Enumeration Date | 2014-07-02 |
| Last Update Date | 2018-03-17 |