| NPI | 1053750422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2505) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN R173566-2) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2020-11-10 |