| NPI | 1972693794 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN CNP3397) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: MN R080266-4) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2018-01-05 |