| NPI | 1144476615 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 183780-3) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1535) | 
| Enumeration Date | 2008-08-15 | 
| Last Update Date | 2020-10-05 |