| NPI | 1649415811 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R-140269-4) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R1402694) |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2009-08-31 |