| NPI | 1669994380 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5316) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1211652) |
| Enumeration Date | 2017-07-14 |
| Last Update Date | 2020-08-10 |