| NPI | 1023448313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 225) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 127304-3) |
| Enumeration Date | 2013-11-22 |
| Last Update Date | 2024-01-30 |