| NPI | 1952719254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R126105-5) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1284) |
| Enumeration Date | 2014-07-30 |
| Last Update Date | 2018-06-04 |