| NPI | 1356816201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN F03180726) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN 03180726) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2018-10-08 |