| NPI | 1336433135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP5113) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 707121) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2020-08-07 |