| NPI | 1124266325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1219) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R134782-7) |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2020-08-07 |