| NPI | 1730335365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 3468-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R172584-7) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 3468-33) | |
| Enumeration Date | 2008-08-14 |
| Last Update Date | 2020-09-15 |