| NPI | 1871920397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3941) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 725983) |
| Enumeration Date | 2013-09-29 |
| Last Update Date | 2020-08-10 |