| NPI | 1710966072 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3168) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 148061-6) |
| Enumeration Date | 2006-01-13 |
| Last Update Date | 2024-04-16 |