| NPI | 1871969147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 8018) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2015029823) |
| 363LF0000X Nurse Practitioner, Family (Licence: TN 21056) | |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2021-03-09 |