| NPI | 1336588094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2512) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1744116) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2020-09-18 |