| NPI | 1366827552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4037) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 6516 - 33) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2018-03-17 |