| NPI | 1275961062 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 3163) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 3163) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2020-11-04 |