| NPI | 1154799781 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP3820) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R157975) |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2024-07-11 |