| NPI | 1598842312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5214) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 1254787) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2013-01-24 |