| NPI | 1255537981 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 318) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1437915) |
| Enumeration Date | 2007-06-21 |
| Last Update Date | 2020-08-10 |