| NPI | 1649458738 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 158) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: SD 1827237) |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2021-11-11 |