| NPI | 1598766677 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 715) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 715) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R-162672-6) | |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2021-03-11 |