| NPI | 1043791304 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5990) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2463285) |
| Enumeration Date | 2018-08-24 |
| Last Update Date | 2019-06-18 |