| NPI | 1851638423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R1032763) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: MN R 1032763) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2013-01-16 |