| NPI | 1295092013 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 291) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN r1915754) |
| Enumeration Date | 2012-04-18 |
| Last Update Date | 2020-08-10 |