| NPI | 1134105703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 56) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1070084) |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2020-09-28 |