| NPI | 1659536019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1458185) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R-145818-5) |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2021-03-26 |