| NPI | 1902358831 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012908) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4850) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2020-04-15 |