| NPI | 1285939215 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 232333-2) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA 2258920) | 
| Enumeration Date | 2011-01-24 | 
| Last Update Date | 2017-12-06 |