| NPI | 1902063415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R147341-6) |
| Additional Taxonomies | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN FLE1-0433-5627) |
| Enumeration Date | 2008-05-21 |
| Last Update Date | 2010-02-16 |