| NPI | 1740553221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1552) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 164547-7) |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2020-08-10 |