| NPI | 1104131606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R 172051-2) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 174) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2020-08-10 |