| NPI | 1912977133 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R184105-1) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA np12228) | 
| Enumeration Date | 2006-01-23 | 
| Last Update Date | 2014-11-04 |