| NPI | 1083017586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1623) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R-1739846) |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2024-03-29 |