| NPI | 1942205471 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R183607-9) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WI 2376) |
| Enumeration Date | 2005-06-21 |
| Last Update Date | 2010-08-16 |