| NPI | 1902053242 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 843) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R117515-4) |
| Enumeration Date | 2008-08-19 |
| Last Update Date | 2023-03-30 |