| NPI | 1538122841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R-83147) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R83147-3) |
| Enumeration Date | 2006-04-08 |
| Last Update Date | 2021-03-11 |