| NPI | 1578997326 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2598) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 184978-1) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2023-01-17 |