| NPI | 1306903273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4513) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2341880) |
| 363LF0000X Nurse Practitioner, Family (Licence: HI APRN433) | |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2019-04-19 |