| NPI | 1912382193 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN CNP 4078) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R1914580) |
| Enumeration Date | 2015-07-29 |
| Last Update Date | 2015-10-28 |