| NPI | 1821300153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 11106) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP06141) |
| 363LF0000X Nurse Practitioner, Family (Licence: ND R28055) | |
| Enumeration Date | 2010-07-01 |
| Last Update Date | 2024-08-23 |