| NPI | 1508207028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2411) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 187348-5) |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2020-08-07 |