| NPI | 1205280005 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5671) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA H112476) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2020-09-29 |