| NPI | 1922173285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MN 477) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MN R 137789-7) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2020-08-07 |