| NPI | 1982687505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP3498) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MN R0844839) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2018-03-17 |