| NPI | 1134576655 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 233420-8) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP4562) |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2021-03-09 |