| NPI | 1578065348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5783) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 225621-30) |
| 163W00000X Registered Nurse (Licence: MN R1656822) | |
| Enumeration Date | 2018-03-07 |
| Last Update Date | 2021-05-03 |