| NPI | 1528392842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1408) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 191974-7) |
| Enumeration Date | 2009-09-21 |
| Last Update Date | 2020-09-30 |