| NPI | 1659569184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4753) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ AP2782) |
| Enumeration Date | 2007-10-10 |
| Last Update Date | 2017-05-01 |