| NPI | 1689065898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4998) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 634030) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 339086) | |
| Enumeration Date | 2015-02-10 |
| Last Update Date | 2018-03-17 |