| NPI | 1902053952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 3164) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 160486-30) |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 3647) | |
| Enumeration Date | 2008-08-21 |
| Last Update Date | 2019-01-22 |