| NPI | 1295718807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 0171) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R143258) |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2020-09-17 |