| NPI | 1174075246 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4842) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R162549-7) |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2016-10-25 |