| NPI | 1740614841 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4081) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R229543-1) |
| Enumeration Date | 2013-08-26 |
| Last Update Date | 2021-11-10 |