| NPI | 1538577499 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 6867) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 218747-1) | 
| Enumeration Date | 2014-07-23 | 
| Last Update Date | 2019-09-23 |