| NPI | 1871523449 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN R1415843) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN CNP1217) |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2018-12-17 |