| NPI | 1861646242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 88) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 144289-0) |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2019-05-07 |