| NPI | 1639697527 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP5261) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2033143) |
| Enumeration Date | 2017-08-31 |
| Last Update Date | 2022-12-13 |