| NPI | 1740417302 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: ND R22718) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN R 158784-9) |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2014-06-16 |