| NPI | 1538451398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1352) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IA 118288) |
| 363L00000X Nurse Practitioner (Licence: MN R 192743-8) | |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2020-09-28 |