| NPI | 1508844978 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1344) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 094958-5) |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2021-01-06 |