| NPI | 1447504014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1540) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 177460-7) |
| Enumeration Date | 2012-11-05 |
| Last Update Date | 2020-09-28 |