| NPI | 1518572908 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10691) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R-220957-9) |
| Enumeration Date | 2020-09-11 |
| Last Update Date | 2023-09-13 |