| NPI | 1154877173 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4841) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 191040-3) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2020-09-28 |