| NPI | 1871517086 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 571) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 118276-5) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 571) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2020-08-07 |