| NPI | 1306258686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 344) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1868432) |
| Enumeration Date | 2014-05-21 |
| Last Update Date | 2024-03-01 |