| NPI | 1902882822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LW0102X Nurse Practitioner, Women's Health (Licence: MN CNP 3433) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 082034-5) |
| Enumeration Date | 2005-12-22 |
| Last Update Date | 2016-11-11 |