| NPI | 1003190372 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 0422) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R104949) |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2017-02-01 |