| NPI | 1710302807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R156446-4) |
| Additional Taxonomies | 363LX0001X Nurse Practitioner, Obstetrics & Gynecology (Licence: MN R156446-4) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2021-01-14 |