| NPI | 1184970477 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1348) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 181012-1) |
| Enumeration Date | 2012-07-24 |
| Last Update Date | 2020-09-18 |