| NPI | 1134551013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2691) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 173572-7) |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2023-03-06 |