| NPI | 1720028053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R0812984) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R0812984) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MN R0812984) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2007-07-09 |