| NPI | 1699833830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 542) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 156927-8) |
| 363L00000X Nurse Practitioner (Licence: IA H-115830) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2020-10-05 |