| NPI | 1306113717 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2028) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R134693-8) |
| Enumeration Date | 2011-11-30 |
| Last Update Date | 2020-08-07 |