| NPI | 1407049315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 3141) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R134108-5) |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2015-03-09 |