| NPI | 1679125157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6452) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN 6452) |
| Enumeration Date | 2019-07-15 |
| Last Update Date | 2019-10-14 |