| NPI | 1154770998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4554) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN F0616270) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2018-09-04 |