| NPI | 1376523456 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 116084-2) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 116084-2) |
| Enumeration Date | 2006-01-17 |
| Last Update Date | 2015-05-28 |