| NPI | 1316379597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP0445) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R1408449) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R 140844-9) | |
| Enumeration Date | 2013-07-30 |
| Last Update Date | 2018-10-22 |