| NPI | 1376516005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 81) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R102325-1) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2019-01-09 |