| NPI | 1467706267 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1570) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1491472) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2021-01-12 |