| NPI | 1982739900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: ND R30131) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R144003-8) |
| 163W00000X Registered Nurse (Licence: WI 149297-030) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2019-10-25 |