| NPI | 1801373063 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 6031) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MN R188127-3) | 
| Enumeration Date | 2018-07-20 | 
| Last Update Date | 2022-08-19 |