| NPI | 1417308701 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5070) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MD R204304) |
| 363L00000X Nurse Practitioner (Licence: MN 2445948) | |
| Enumeration Date | 2016-06-28 |
| Last Update Date | 2020-10-05 |