| NPI | 1629323753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2889) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN F0612214) |
| 163W00000X Registered Nurse (Licence: MN R 156881-3) | |
| Enumeration Date | 2012-07-15 |
| Last Update Date | 2021-03-10 |