| NPI | 1114314093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R191121-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R33406) |
| Enumeration Date | 2015-04-19 |
| Last Update Date | 2015-04-19 |