| NPI | 1457795320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1873) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1405277) |
| Enumeration Date | 2013-04-23 |
| Last Update Date | 2020-08-10 |