| NPI | 1770904633 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP0025) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN R217480-8) |
| Enumeration Date | 2013-12-19 |
| Last Update Date | 2018-12-26 |