| NPI | 1194332460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10118) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA A160741) |
| Enumeration Date | 2020-09-30 |
| Last Update Date | 2023-05-10 |