| NPI | 1790051894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP1716) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R138911-5) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R138911-5) | |
| Enumeration Date | 2012-03-22 |
| Last Update Date | 2021-04-15 |