| NPI | 1215992706 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R117259-7) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R117259-7) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R-117259-7) | |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2022-11-07 |