| NPI | 1306394473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4819) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R2081823) |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2020-08-10 |