| NPI | 1700323680 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5025) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R-188128-6) |
| Enumeration Date | 2017-01-30 |
| Last Update Date | 2020-08-10 |