| NPI | 1154609824 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R172014-3) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 3509) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2020-08-07 |