| NPI | 1366717472 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP2909) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1357192) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2015-11-19 |