| NPI | 1629451869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN 3964) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 199200-7) |
| Enumeration Date | 2015-07-07 |
| Last Update Date | 2024-07-10 |