| NPI | 1114195120 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 1581) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R143808-2) |
| Enumeration Date | 2008-02-12 |
| Last Update Date | 2018-09-24 |