| NPI | 1285969642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 764) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R141563-6) |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2020-10-05 |