| NPI | 1235401464 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R217101-8) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IA A-117142) |
| Enumeration Date | 2012-02-03 |
| Last Update Date | 2021-02-10 |