| NPI | 1417293572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 2080) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 147784-9) |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2015-06-04 |