| NPI | 1467853002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 3410) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN R138208-6) |
| Enumeration Date | 2014-09-15 |
| Last Update Date | 2020-09-14 |