| NPI | 1831110055 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R19519) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 173463-4) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2022-04-18 |