| NPI | 1760817563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1014) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1686290) |
| Enumeration Date | 2013-09-11 |
| Last Update Date | 2024-07-19 |