| NPI | 1417304163 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8300) |
| Additional Taxonomies | 364S00000X Clinical Nurse Specialist (Licence: MN CNS 0505) |
| Enumeration Date | 2016-05-23 |
| Last Update Date | 2021-09-02 |