| NPI | 1568487098 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN 2983) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN R131351-8) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2019-12-10 |