| NPI | 1013908383 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN CNP0965) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN R1172555) |
| Enumeration Date | 2005-11-04 |
| Last Update Date | 2015-03-04 |