| NPI | 1194725838 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2551) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R096288) |
| Enumeration Date | 2005-07-22 |
| Last Update Date | 2020-09-18 |