| NPI | 1154308161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R124847-6) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R124847-6) |
| Enumeration Date | 2005-12-30 |
| Last Update Date | 2018-10-16 |