| NPI | 1780747071 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN CNP2731) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN R1502523) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2018-08-22 |