| NPI | 1700062304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN R201278-2) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 700352) |
| 363LF0000X Nurse Practitioner Family (Licence: ND R38151) | |
| Enumeration Date | 2008-01-14 |
| Last Update Date | 2013-11-20 |