| NPI | 1649243841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1593) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R128998-5) |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2022-01-07 |