| NPI | 1699034959 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 241) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R181803-9) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT 103167) | |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2021-09-29 |