| NPI | 1720333685 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 2507) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 123943-0) | 
| Enumeration Date | 2012-07-17 | 
| Last Update Date | 2024-10-17 |