| NPI | 1629083068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1619) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1343737) |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2021-06-07 |