| NPI | 1407875768 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4338) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209-004764) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R231593-9) | |
| Enumeration Date | 2006-07-18 |
| Last Update Date | 2022-07-21 |