| NPI | 1699755256 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1973) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R145550-2) |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2019-06-19 |