| NPI | 1649524539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5865) |
| Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: CO 129613) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2020-08-07 |