| NPI | 1871658625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 2354) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1320255) |
| 363LN0000X Nurse Practitioner, Neonatal (Licence: MN R1320255) | |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2020-08-10 |