| NPI | 1306854484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2012011992) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 0102581) |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2017-03-18 |