| NPI | 1376098806 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4675) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R-195123-9) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2021-08-11 |