| NPI | 1831422344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 401) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R-160737-6) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN R-160737-6) | |
| Enumeration Date | 2009-09-15 |
| Last Update Date | 2020-10-06 |