| NPI | 1629446588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4179) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 173947-7) |
| Enumeration Date | 2015-09-09 |
| Last Update Date | 2021-03-11 |