| NPI | 1679955884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP3847) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R 171469-6) |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2024-01-10 |