| NPI | 1134649965 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5351) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1961232) |
| 163W00000X Registered Nurse (Licence: MN 1961232) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2020-08-10 |