| NPI | 1609097567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 70) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R090017-1) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2020-09-17 |