| NPI | 1316252810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN CNP2804) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN R158560-5) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2017-12-13 |