| NPI | 1982120085 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 5182) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2171296) |
| 163W00000X Registered Nurse (Licence: IA 131646) | |
| Enumeration Date | 2017-08-21 |
| Last Update Date | 2019-11-14 |