| NPI | 1134594310 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4396) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 156864-8) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2024-07-03 |