| NPI | 1568434793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1031) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R102336-1) |
| Enumeration Date | 2006-02-02 |
| Last Update Date | 2023-11-15 |