| NPI | 1659309342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1578) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R09632521) |
| 363L00000X Nurse Practitioner (Licence: MN 932521) | |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2020-09-28 |