| NPI | 1609144187 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: MN 2067) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: MN R 164279-7) |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2022-05-04 |