| NPI | 1154796449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R184629-2) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 4340) |
| Enumeration Date | 2015-12-11 |
| Last Update Date | 2020-10-06 |