| NPI | 1710305982 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R40020) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP-4788) |
| Enumeration Date | 2014-04-03 |
| Last Update Date | 2016-10-06 |