| NPI | 1548339674 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 814) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R122357-2) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2019-04-25 |