| NPI | 1568743524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP3765) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R176425-1) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R1764251) | |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2016-12-19 |