| NPI | 1073882734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1529) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 204867-5) |
| Enumeration Date | 2011-12-23 |
| Last Update Date | 2020-08-07 |