| NPI | 1649504044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R94857-3) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD 0073113) |
| Enumeration Date | 2009-10-01 |
| Last Update Date | 2009-10-01 |