| NPI | 1922261338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2256) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R-1679100) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MN R1679100) | |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2021-03-08 |