| NPI | 1508277500 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2126) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN r192202-2) |
| Enumeration Date | 2014-05-13 |
| Last Update Date | 2020-10-05 |