| NPI | 1730102443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL APRN11029824) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1962) |
| 363L00000X Nurse Practitioner (Licence: MN R-180307-3) | |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2024-04-04 |