| NPI | 1588188692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5320) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN F07171259) |
| Enumeration Date | 2017-07-31 |
| Last Update Date | 2018-10-29 |