| NPI | 1770679037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R112373-7) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R19132) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2020-12-22 |