| NPI | 1194021766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4426) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R166069-8) |
| Enumeration Date | 2011-01-31 |
| Last Update Date | 2020-05-28 |