| NPI | 1831303767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN F0611060) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: CA RN529575) |
| 163W00000X Registered Nurse (Licence: MN R203450-8) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2012-10-08 |