| NPI | 1487066304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1685) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1664115) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R1664115) | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2021-02-16 |