| NPI | 1083168009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4652) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 177372-1) |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2020-08-07 |