| NPI | 1881797462 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A-122356) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R19389) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R090749-1) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 4055) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2016-06-08 |