| NPI | 1912974395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R-115456-0) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN MNR1154560) |
| Enumeration Date | 2006-03-03 |
| Last Update Date | 2008-07-30 |