| NPI | 1144642893 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R153973-2) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 40319) |
| 363LF0000X Nurse Practitioner, Family (Licence: MT RN-70309) | |
| 363LF0000X Nurse Practitioner, Family (Licence: WI 176021) | |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |