| NPI | 1558712026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4636) |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MN 149136-2) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2020-08-10 |