| NPI | 1740430792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2842) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 160150-5) |
| Enumeration Date | 2008-09-26 |
| Last Update Date | 2022-03-21 |