| NPI | 1225015951 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2311) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R124599-0) |
| Enumeration Date | 2005-12-23 |
| Last Update Date | 2020-10-05 |