| NPI | 1154393643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R143113-1) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1356) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2020-10-05 |