| NPI | 1447704622 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4830) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 191471-3) |
| Enumeration Date | 2016-08-05 |
| Last Update Date | 2016-10-05 |