| NPI | 1043566730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 137) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 177235-3) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2024-02-09 |