| NPI | 1588649180 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1601) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1033092) |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2020-09-18 |