| NPI | 1326365693 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R-110746-5) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 110746-5) |
| Enumeration Date | 2010-04-27 |
| Last Update Date | 2013-05-06 |