| NPI | 1891709952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 86) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1346789) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 86) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2021-03-24 |