| NPI | 1770834459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 6245-33) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 210533-0) |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2015-06-17 |