| NPI | 1619274586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 240) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 156652-7) |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2020-08-10 |