| NPI | 1821423476 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP0968) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 177572-9) |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2018-12-07 |