| NPI | 1700290319 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2412) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: SC 22871) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2024-01-10 |