| NPI | 1720689920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 7897) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R147035-4) |
| Enumeration Date | 2020-11-04 |
| Last Update Date | 2023-01-11 |