| NPI | 1265977466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP4935) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN C4935) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO APN.0992867-NP) | |
| Enumeration Date | 2016-12-23 |
| Last Update Date | 2021-09-22 |