| NPI | 1528474392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R-098129-7) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 98129-7) |
| Enumeration Date | 2014-07-01 |
| Last Update Date | 2014-11-07 |