| NPI | 1790891729 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN R70176-5) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: FL 1769372) |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2014-06-25 |