| NPI | 1477865913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 126) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R169795-9) |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2020-08-10 |