| NPI | 1265419733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN CNP 2830) |
| Additional Taxonomies | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: MN R 124246-9) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2016-11-11 |