| NPI | 1205271004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 7752) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 158207-7) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2021-07-13 |