| NPI | 1700032505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 1861) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R134720-9) |
| Enumeration Date | 2008-08-12 |
| Last Update Date | 2021-12-20 |