| NPI | 1760818009 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3232) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R177565-1) |
| Enumeration Date | 2013-09-18 |
| Last Update Date | 2020-09-28 |