| NPI | 1609850866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 130067-030) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 088575-9) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 2291-033) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-08 |