| NPI | 1780132118 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 4816) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MN RN238024-9) |
| Enumeration Date | 2016-09-14 |
| Last Update Date | 2021-01-06 |