| NPI | 1659776755 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3040) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 189085-3) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2024-05-29 |