| NPI | 1851585335 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 848) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 144675-7) | 
| Enumeration Date | 2007-08-28 | 
| Last Update Date | 2020-08-07 |