| NPI | 1780175752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6068) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN 2020758) |
| Enumeration Date | 2018-05-24 |
| Last Update Date | 2021-04-08 |