| NPI | 1609802453 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R 147155-7) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 147155-7) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2014-05-12 |