| NPI | 1407256712 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 242) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R146858-6) |
| Enumeration Date | 2014-08-25 |
| Last Update Date | 2024-01-16 |