| NPI | 1366415903 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 320) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1215221) |
| Enumeration Date | 2006-02-13 |
| Last Update Date | 2020-09-01 |