| NPI | 1740595552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1465) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R133141-9) |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: WI 7993) | |
| Enumeration Date | 2010-08-17 |
| Last Update Date | 2020-08-07 |