| NPI | 1255922928 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8052) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 2485887) |
| Enumeration Date | 2021-01-26 |
| Last Update Date | 2021-03-12 |