| NPI | 1699752121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1154) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R087079-3) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2019-05-06 |