| NPI | 1588038830 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4288) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R-1929698) | 
| Enumeration Date | 2015-11-24 | 
| Last Update Date | 2024-09-11 |