| NPI | 1083602395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN R084250-1) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 084250-1) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2009-01-12 |