| NPI | 1699035360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2012013879) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R180584-8) |
| Enumeration Date | 2012-05-29 |
| Last Update Date | 2012-09-24 |