| NPI | 1972603363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R 187403-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 612679) |
| Enumeration Date | 2006-09-25 |
| Last Update Date | 2010-05-06 |