| NPI | 1073272365 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8949) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: SD R045687) |
| 163W00000X Registered Nurse (Licence: MN 2345352) | |
| Enumeration Date | 2021-12-14 |
| Last Update Date | 2022-01-26 |