| NPI | 1912461955 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: MN 1810749) |
| Additional Taxonomies | 163WP2201X Registered Nurse, Ambulatory Care (Licence: MN 1810749) |
| Enumeration Date | 2019-01-23 |
| Last Update Date | 2019-01-23 |