| NPI | 1902201940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 1405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN 1798683) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2020-08-10 |