| NPI | 1689650483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN CNP 2312) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 109659-2) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2016-03-01 |