| NPI | 1740394824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R 168305-7) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R 168305-7) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 0613) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2023-12-01 |