| NPI | 1679142756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 8312) |
| Additional Taxonomies | 2085R0001X Radiology, Radiation Oncology (Licence: MN F06210306) |
| Enumeration Date | 2021-06-22 |
| Last Update Date | 2021-09-13 |