| NPI | 1619424777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4778) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R177600-3) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2019-05-07 |