| NPI | 1619108420 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R30610) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2520439) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 11312) | |
| Enumeration Date | 2009-07-29 |
| Last Update Date | 2024-12-02 |