| NPI | 1770776114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1097) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1458868) |
| Enumeration Date | 2007-08-20 |
| Last Update Date | 2020-10-06 |