| NPI | 1114372612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 169191-3) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP 4381) |
| 363LW0102X Nurse Practitioner, Women's Health (Licence: MN CNP 4381) | |
| Enumeration Date | 2016-05-03 |
| Last Update Date | 2021-03-11 |