| NPI | 1639803117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R29899) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 9450) |
| Enumeration Date | 2022-07-12 |
| Last Update Date | 2022-09-26 |