| NPI | 1619231834 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1087) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R204842-6) |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2023-03-29 |