| NPI | 1881081248 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MN CNP6959) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 206564) |
| Enumeration Date | 2015-04-22 |
| Last Update Date | 2019-09-27 |