| NPI | 1174097497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10298) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2466645) |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2024-01-11 |