| NPI | 1124251194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R147877-0) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner Women's Health (Licence: MN R 147877-0) |
| Enumeration Date | 2009-08-25 |
| Last Update Date | 2020-09-23 |