| NPI | 1245606961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4008) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R174346-3) |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2021-03-11 |