| NPI | 1124392295 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN F0711440) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R161373-9) |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2019-06-20 |