| NPI | 1538144944 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 0851) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R148078-4) |
| Enumeration Date | 2005-12-08 |
| Last Update Date | 2021-03-18 |