| NPI | 1609289446 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN 2649) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN R 170276-3) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2020-06-08 |