| NPI | 1780040782 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4266) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4266) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 1866340) | |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2020-09-28 |