| NPI | 1689633042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2024) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN R-137318-9) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2021-01-14 |