| NPI | 1629363429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 6292) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SD CP000888) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A-109497) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 7871-33) | |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2024-01-15 |