| NPI | 1841304763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 3230) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R128573-0) |
| 363LF0000X Nurse Practitioner, Family (Licence: IN 71001302A) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2020-08-10 |