| NPI | 1982626479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ND R28212) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP 4187) |
| Enumeration Date | 2006-07-24 |
| Last Update Date | 2016-09-29 |