| NPI | 1174077184 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4834) | 
| Additional Taxonomies | 163WX0003X Registered Nurse, Obstetric, Inpatient (Licence: MN 204892-1) | 
| Enumeration Date | 2016-08-08 | 
| Last Update Date | 2016-10-06 |