| NPI | 1235175753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN 417) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MN R1121959) |
| 363LF0000X Nurse Practitioner Family (Licence: MN R1121959) | |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2021-03-11 |