| NPI | 1790294874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 5447) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1535150) |
| Enumeration Date | 2017-09-21 |
| Last Update Date | 2019-10-28 |