| NPI | 1972081453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 8037) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IA 138221) |
| 363L00000X Nurse Practitioner (Licence: TX F07181331) | |
| Enumeration Date | 2018-08-06 |
| Last Update Date | 2022-06-06 |