| NPI | 1386990315 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 7466) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 129655) |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2020-12-01 |