| NPI | 1811150691 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3971) |
| Additional Taxonomies | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: MN R1479876) |
| Enumeration Date | 2008-07-02 |
| Last Update Date | 2021-03-11 |