| NPI | 1033521901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1218) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 161529-0) |
| Enumeration Date | 2014-05-28 |
| Last Update Date | 2020-08-10 |