| NPI | 1700223468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 10039) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 185240-30) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2023-03-21 |