| NPI | 1669459004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1571) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1374816) |
| Enumeration Date | 2005-12-28 |
| Last Update Date | 2020-09-17 |