| NPI | 1417570391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8397) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2206543) |
| Enumeration Date | 2020-05-26 |
| Last Update Date | 2021-10-26 |