| NPI | 1972789022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN R217258-3) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP009590) |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2014-04-16 |