| NPI | 1417251042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1015) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R182631-9) |
| Enumeration Date | 2010-12-22 |
| Last Update Date | 2020-08-07 |