| NPI | 1013077304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP 0382) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R204163-0) |
| Enumeration Date | 2006-12-09 |
| Last Update Date | 2022-12-08 |