| NPI | 1770818379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 5892) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA 60112441) |
| Enumeration Date | 2009-10-15 |
| Last Update Date | 2021-09-17 |