| NPI | 1942673447 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 4123) | 
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: MN CNP 4123) | 
| Enumeration Date | 2015-11-05 | 
| Last Update Date | 2019-10-15 |