| NPI | 1871034645 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4795) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 147427-9) |
| 163W00000X Registered Nurse (Licence: WI 194731-30) | |
| Enumeration Date | 2017-03-13 |
| Last Update Date | 2017-03-13 |