| NPI | 1225439003 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1089) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 180164-8) |
| Enumeration Date | 2014-09-11 |
| Last Update Date | 2020-08-10 |