| NPI | 1679768956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 738) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 151778-3) |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2020-08-07 |