| NPI | 1568607679 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN R 71046-8) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 71046-8) |
| Enumeration Date | 2008-12-04 |
| Last Update Date | 2008-12-04 |