| NPI | 1013984491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R-116373-9) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN MNR1163739) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2013-06-14 |