| NPI | 1689778060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1005) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 147047-7) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2023-08-16 |