| NPI | 1053719237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1577) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 1577) |
| Enumeration Date | 2014-12-19 |
| Last Update Date | 2021-02-02 |