| NPI | 1689100182 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5187) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP5187) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2017-05-04 |
| Last Update Date | 2020-08-07 |