| NPI | 1235109596 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3127) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R095322-5) |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2021-05-06 |