| NPI | 1619289550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN APRN-CNP0871) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1222476) |
| 363L00000X Nurse Practitioner (Licence: MN R122247-6) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R122247-6) | |
| Enumeration Date | 2010-07-08 |
| Last Update Date | 2020-11-25 |