| NPI | 1902190382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN R173579-8) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WI 170818-30) |
| Enumeration Date | 2011-06-03 |
| Last Update Date | 2011-06-03 |