| NPI | 1316490014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4564) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R195367-7 CNP 4564) |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2020-09-29 |