| NPI | 1689928491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4916) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WY 22523.1208) |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2016-12-20 |