| NPI | 1861882029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CA 95011529) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 3442) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R2068891) | |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2021-01-26 |