| NPI | 1376586792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3228) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1222515) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2019-06-17 |