| NPI | 1659630366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 329) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1792964) |
| Enumeration Date | 2012-05-15 |
| Last Update Date | 2020-05-26 |