| NPI | 1669716767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 61) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2106038) |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2021-04-12 |