| NPI | 1902254899 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN CNP4632) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 212074-2) |
| Enumeration Date | 2016-06-01 |
| Last Update Date | 2017-04-20 |