| NPI | 1811322878 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 6162) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R214762-8) |
| Enumeration Date | 2013-09-10 |
| Last Update Date | 2014-12-27 |