| NPI | 1497940142 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 625) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R32414) |
| 363L00000X Nurse Practitioner (Licence: MN R 162287-2) | |
| Enumeration Date | 2007-09-06 |
| Last Update Date | 2020-08-07 |