| NPI | 1518946821 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2069) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 109002-2) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2023-03-14 |