| NPI | 1720027113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2005005527) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R138246-8) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2016-05-12 |