| NPI | 1134177561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R079952-8) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 90758-030) |
| Enumeration Date | 2006-05-05 |
| Last Update Date | 2008-04-09 |