| NPI | 1740635580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4467) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP4467) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2020-08-07 |