| NPI | 1043658057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2836) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2140227) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MN R214022-7) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2020-08-07 |