| NPI | 1104224666 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2792) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 162274-6) |
| Enumeration Date | 2014-12-16 |
| Last Update Date | 2020-03-04 |