| NPI | 1750353728 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1644) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R075612-1) |
| Enumeration Date | 2006-02-03 |
| Last Update Date | 2021-08-19 |