| NPI | 1689984569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1500) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1659573) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN F0910433) | |
| Enumeration Date | 2010-10-13 |
| Last Update Date | 2020-09-28 |