| NPI | 1366875486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1240) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R158313-1) |
| Enumeration Date | 2013-08-13 |
| Last Update Date | 2021-03-11 |