| NPI | 1124218102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 722) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 137363-9) |
| Enumeration Date | 2007-07-26 |
| Last Update Date | 2020-03-26 |