| NPI | 1265499321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2443) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1470684) |
| Enumeration Date | 2006-05-01 |
| Last Update Date | 2018-10-01 |