| NPI | 1558512475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8808) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1871665) |
| 363L00000X Nurse Practitioner (Licence: NV APRN001865) | |
| Enumeration Date | 2008-10-09 |
| Last Update Date | 2021-11-30 |