| NPI | 1205945821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP 3550) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R130557-1) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2020-11-11 |