| NPI | 1942625264 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024171558) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1939280) |
| Enumeration Date | 2014-02-24 |
| Last Update Date | 2016-09-01 |