| NPI | 1306229224 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP4902) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NE 111820) |
| Enumeration Date | 2015-07-09 |
| Last Update Date | 2020-08-07 |