| NPI | 1467877688 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP1935)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 185486-0)  | 
| Enumeration Date | 2014-02-25 | 
| Last Update Date | 2024-06-06 |