| NPI | 1114589181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6802) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2020732) |
| Enumeration Date | 2019-07-01 |
| Last Update Date | 2022-08-29 |