| NPI | 1871962639 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4143) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP 4143) |
| 363L00000X Nurse Practitioner (Licence: MN 1636499) | |
| Enumeration Date | 2015-09-22 |
| Last Update Date | 2020-08-07 |