| NPI | 1275814659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R162986-2) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN CNP3513) |
| Enumeration Date | 2011-08-30 |
| Last Update Date | 2021-01-12 |