| NPI | 1811917594 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MN R069132-5) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: ND R14864) |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-08 |