| NPI | 1689154619 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6212) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN F08180229) |
| Enumeration Date | 2018-08-20 |
| Last Update Date | 2020-08-07 |