| NPI | 1861483257 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2426284) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45699) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 002105) | |
| Enumeration Date | 2005-11-03 |
| Last Update Date | 2017-11-29 |